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Percutaneous transhepatic cholangiogram - Overview

Alternative Names

PTCA; Cholangiogram - PTCA

Definition of Percutaneous transhepatic cholangiogram :

A percutaneous transhepatic cholangiogram (PTCA) is an x-ray of the bile ducts, the tubes that carry bile from the liver to the gallbladder and small intestine.

How the test is performed:

The test is performed in a radiology department by a radiologist.

You will be asked to lie on your back on the x-ray table. The health care provider will clean the upper right side of your belly area and then apply a numbing medicine.

X-rays are used to help the health care provider locate your liver and bile ducts. A long, thin, flexible needle is then inserted through the skin into the liver. The health care provider injects dye, called contrast medium, into the bile ducts. Contrast helps highlight certain areas they can be seen better. More x-rays are taken as the dye flows through the bile ducts into the small intestine. This can be seen on a nearby video monitor.

How to prepare for the test:

Inform the health care provider if you are pregnant. You will be given a hospital gown to wear and will be asked to remove all jewelry.

You will be asked not to eat or drink anything for 6 hours prior to the exam.

Tell your health care provider if you are taking any blood thinners such as warfarin (coumadin) or Plavix (clopidrogrel).

How the test will feel:

There will be a sting as the anesthetic is given and some discomfort as the needle is advanced into the liver. You may be given medication for sedation and/or pain control. Generally, the x-ray itself causes little or no discomfort.

Why the test is performed:

This test can help diagnose the cause of a bile duct blockage.

Bile a liquid released by the liver. It contains cholesterol, bile salts, and waste products. Bile salts help your body break down (digest) fats. A blockage of the bile duct can lead to swelling of the gallbladder or pancreas.

This results of this test may help your doctor plan treatments for a bile duct blockage. For example, it can help determine where a drainage tube or stent can be placed.

  • Reviewed last on: 1/31/2011
  • David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; Jason Levy, MD, Northside Radiology Associates, Atlanta, Georgia. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

References

Lidofsky S. Jaundice. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease. 9th ed. Philadelphia, Pa: Saunders Elsevier; 2010:chap 20.

Wael E.A. Saad, Michael J. Wallace, Joan C. Wojak, Sanjoy Kundu. Quality Improvement Guidelines for Percutaneous Transhepatic Cholangiography, Biliary Drainage, and Percutaneous Cholecystostomy. Journal of Vascular and Interventional Radiology Vol. 21, Issue 6, Pages June 2010. 789-795.

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